Monkeypox Outbreak — Nine States, May 2022
Authors: Faisal S. Minhaj, Yasmin P. Ogale, Florence Whitehill, Jordan Schultz, Mary Foote, Whitni Davidson, Christine M. Hughes, Kimberly Wilkins, Laura Bachmann, Ryan Chatelain, Marisa A.P. Donnelly, Rafael Mendoza, Barbara L. Downes, Mellisa Roskosky, Meghan Barnes, Glen R. Gallagher, Nesli Basgoz, Victoria Ruiz, Nang Thu Thu Kyaw, Amanda Feldpausch, Amy Valderrama, Francisco Alvarado-Ramy, Chad H. Dowell, Catherine C. Chow, Yu Li, Laura Quilter, John Brooks, Demetre C. Daskalakis, R. Paul McClung, Brett W. Petersen, Inger Damon, Christina Hutson, Jennifer McQuiston, Agam K. Rao, Ermias Belay, Andrea M. McCollum, Kristina Angelo, Matt Arduino, Ray Arthur, Nicolle Baird, Jonathan Batross, Amy Beeson, Jui Bhingarde, Michael Bowen, Clive Brown, Catherine M. Brown, Alexis Burakoff, Kelly Charniga, Tai-Ho Chen, Sherry Chen, Patrick Clay, James Cope, Jennifer Cope, Michelle Addo Dankwa, Lisa Delaney, Marie De Perio, Michelle Decenteceo, Kristin Delea, Jeffrey B. Doty, Jeffrey Duchin, Joseph Dunlap, Ryan Fagan, Bryce Furness, Shannon Gearhart, Crystal Gigante, Aubrey Gilliland, Lucas Gosdin, Isabel Griffin, Amanda Groccia, Sarah Guagliardo, Yonette Hercules, Kelly Jackson, Paulino Jarquin, Rachel Kachur, Alexander Kallen, Raymond Kao, Aubree Kelly, Mohammed Khan, Theodora Khan, Aaron Kofman, Krista Kornylo, David Kuhar, Michael LaFlam, Robert Lash, Andrew Lashombe, David Lowe, Amanda MacGurn, Nina Masters, Keegan McCaffrey, Jenna L. Mink, Benjamin Monroe, Clint N. Morgan, Yoshinori Nakazawa, Julie Nash, Terese Navarra, Donovan Newton, Modupe Osinubi, Valentina Osorio, Christine Pearson, Julia Petras, David Philpott, Amy Pickrel, Brandon Potvin, Lalita Priyamvada, Araceli Rey, Erin Ricketts, Sergio Rodriguez, Julie Rushmore, Panayampalli S. Satheshkumar, Hannah Segaloff, Ahlia Sekkarie, Artee Sharma, Emily Sims, Dallas Smith, Teresa Smith, Todd Smith, Dipesh Solanky, Ian Spiknall, Danielle R. Stanek, Mark Stenger, Frank Strona, Kara Tardivel, Eishita Tyagi, Pascale Wortley, Diana Valencia, Michelle Waltenburg, Erin Whitehouse, Marcia Wong
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

On May 17, 2022, the Massachusetts Department of Public Health (MDPH) Laboratory Response Network (LRN) laboratory confirmed the presence of orthopoxvirus DNA via real-time polymerase chain reaction (PCR) from lesion swabs obtained from a Massachusetts resident. Orthopoxviruses include Monkeypox virus, the causative agent of monkeypox. Subsequent real-time PCR testing at CDC on May 18 confirmed that the patient was infected with the West African clade of Monkeypox virus. Since then, confirmed cases* have been reported by nine states. In addition, 28 countries and territories,† none of which has endemic monkeypox, have reported laboratory-confirmed cases. On May 17, CDC, in coordination with state and local jurisdictions, initiated an emergency response to identify, monitor, and investigate additional monkeypox cases in the United States. This response has included releasing a Health Alert Network (HAN) Health Advisory, developing interim public health and clinical recommendations, releasing guidance for LRN testing, hosting clinician and public health partner outreach calls, disseminating health communication messages to the public, developing protocols for use and release of medical countermeasures, and facilitating delivery of vaccine postexposure prophylaxis (PEP) and antivirals that have been stockpiled by the U.S. government for preparedness and response purposes. On May 19, a call center was established to provide guidance to states for the evaluation of possible cases of monkeypox, including recommendations for clinical diagnosis and orthopoxvirus testing. The call center also gathers information about possible cases to identify interjurisdictional linkages. As of May 31, this investigation has identified 17§ cases in the United States; most cases (16) were diagnosed in persons who identify as gay, bisexual, or men who have sex with men (MSM). Ongoing investigation suggests person-to-person community transmission, and CDC urges health departments, clinicians, and the public to remain vigilant, institute appropriate infection prevention and control measures, and notify public health authorities of suspected cases to reduce disease spread. Public health authorities are identifying cases and conducting investigations to determine possible sources and prevent further spread. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.¶.